Analysis of morphological changes in the soft tissue following orthognathic surgery in patients with severe (over 10 mm) facial asymmetry

This study aims to compare the quantitative differences in soft tissue changes among patients who underwent orthognathic surgery for facial asymmetry correction. A total of 24 patients treated between January 2015 and December 2022 were included. Data were collected at four time points: T0 (preoperative), T1 (3 days postoperatively), T2 (6 months postoperatively), and T3 (12 months postoperatively). Facial asymmetry was defined as a menton deviation of ≥10 mm from the midsagittal plane, with all patients undergoing maxillary canting correction during surgery.

Soft tissue changes were assessed using five anatomical landmarks: malar prominence (MP), alar curvature point (Ac), soft tissue gonion (Go), mid-ramus (mR), and cheilion (Ch). No sex-related differences were observed. Comparison between T2 and T3 revealed that four out of 24 patients (16.6 %) exhibited statistically significant differences. T3 demonstrated the lowest asymmetry index and the greatest soft tissue changes from T0. The deviated side exhibited the most pronounced changes, with cheilion showing the highest degree of symmetry improvement.

These findings provide insight into the morphological adaptations of soft tissue following orthognathic surgery and may assist in predicting postoperative outcomes.